Growing up in Sweden during the 90s and early 2000s, mental health was not a topic that received much attention. Self-harm, in particular, was something many of us didn’t understand or even know existed. Without access to social media or the vast resources of the internet, information was limited, and conversations around such sensitive issues were rare. Now, as a therapist working in Singapore with children and adolescents, I’ve come to appreciate the importance of addressing self-injury openly and understanding its nuances.
What Does Self-Harm Look Like?
Self-harm, also known as nonsuicidal self-injury (NSSI), is when someone intentionally hurts themselves to cope with emotional pain, stress, or overwhelming feelings. It’s a way to release tension or regain a sense of control, even if only temporarily.
What Research Tells Us
A recent systematic review by Farkas et al. (2024) highlights how common self-harm is among adolescents, with around one in six engaging in these behaviours. It also points to gender differences in methods. While the reasons behind these patterns aren’t fully understood, researchers believe they’re influenced by how society shapes emotional expression.
Approximately 21.4% of female adolescents and 13.7% of male adolescents engage in NSSI. This data, collected from 17 countries across North America, Australia, Europe, and Asia, highlights the need for greater awareness and understanding. Studies show that girls and women are more likely to use methods like cutting or scratching their skin. These forms of self-harm are often visible and may stem from a need to express or cope with inner emotional struggles. On the other hand, boys and men tend to engage in riskier behaviours, like hitting themselves, burning, or deliberately taking physical risks. These methods might align with societal pressures to appear strong or suppress emotional vulnerability.
Risk factors in girls
• Social Media Influence: Higher engagement with social media platforms has been linked to increased instances of self-harm. The pressure to conform to specific beauty standards or lifestyles and constant comparisons to peers can exacerbate feelings of inadequacy or distress.
• Communication Challenges: Difficulties in confiding in family members or lacking a supportive network can lead to feelings of isolation. When girls feel they cannot share their struggles openly, they may turn to self-harm as a coping mechanism.
Risk factors in boys
• Emotional Suppression: Cultural norms may discourage boys from openly expressing sadness or fear, prompting alternative outlets for these emotions.
• Bullying Experiences: Both being bullied and bullying others are associated with self-harm among boys. These experiences can contribute to feelings of anger, shame, or helplessness, which may be expressed through self-injury.
• Identity Challenges: Struggles with same-sex attraction or uncertainty about one’s identity can add emotional stress. Without adequate support or the ability to express these feelings, boys may resort to self-harm as a way to cope.
It is important to note that these findings are patterns, not rules. While gender offers one lens to understand self-harm, it’s not the whole picture. People who identify as nonbinary or transgender may face unique challenges that make them more vulnerable to self-harm. Studies like those by Aspeqvist et al. (2024) emphasise the importance of creating inclusive, non-judgmental spaces where everyone feels safe to seek help. Each individual’s experience is shaped by their emotional needs and circumstances, emphasising the importance of empathy and tailored support. Self-harm doesn’t fit neatly into categories, and it’s essential to approach each person as an individual with their own story.
Supporting Our Youth
It’s important to understand the different factors that affect young people so we can provide the right support. Here are some key points to consider:
• Open Communication: We should encourage young people to talk openly about their feelings and experiences. By creating a safe space for them to express themselves, we can help reduce feelings of loneliness.
• Education and Awareness: It’s essential to raise awareness about mental health and self-harm in schools and communities. This can help break the stigma around these topics and encourage early help.
• Professional Help: Encourage young people, their parents, teachers, or anyone concerned about someone in their life to seek support from mental health professionals.
• Inclusive Environments: Create spaces where all youths, regardless of gender or identity, feel accepted and understood. This inclusivity can help lessen some of the pressures that lead to self-harm.
Conclusion
Reflecting on my upbringing in Sweden, I recognise the importance of awareness and open dialogue around mental health issues like self-harm. While we didn’t have the same access to information or platforms for discussion back then, we now have the opportunity to address these concerns more effectively. By presenting the facts and understanding the nuances across different genders, we can better support the well-being of our adolescents.
Self-harm is a complex issue that doesn’t have a one-size-fits-all solution. It requires empathy, understanding, and a willingness to listen. By fostering environments where young people feel safe to express their feelings, we can help them develop healthier coping mechanisms and navigate the challenges of adolescence more effectively.
At the end of the day, self-harm is about a person’s relationship with their emotions. Whether someone cuts, hits, or engages in other behaviours, the focus should always be on understanding their pain and helping them heal.
To meet with a professional psychologist or counsellor, call The Other Clinic at 8809 0659 or email us hello@theotherclinic.sg.
References:
1. Aspeqvist, E., Andersson, H., Korhonen, L. et al. Measurement and stratification of nonsuicidal self-injury in adolescents. BMC Psychiatry 24, 107 (2024). https://doi.org/10.1186/s12888-024-05535-3
2. Denton E, Álvarez K. The Global Prevalence of Nonsuicidal Self-Injury Among Adolescents. JAMA Netw Open. 2024;7(6):e2415406. doi:10.1001/jamanetworkopen.2024.15406
3. Diggins E, Heuvelman H, Pujades-Rodriguez M, House A, Cottrell D, Brennan C. Exploring gender differences in risk factors for self-harm in adolescents using data from the Millennium Cohort Study. J Affect Disord. 2024 Jan 15;345:131-140. doi: 10.1016/j.jad.2023.10.106. Epub 2023 Oct 18. PMID: 37863369.
4. Farkas, B.F., Takacs, Z.K., Kollárovics, N. et al. The prevalence of self-injury in adolescence: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 33, 3439–3458 (2024). https://doi.org/10.1007/s00787-023-02264-y
5. Sornberger MJ, Heath NL, Toste JR, McLouth R. Nonsuicidal self-injury and gender: patterns of prevalence, methods, and locations among adolescents. Suicide Life Threat Behav. 2012;42(3):266–78
6. Victor SE, Muehlenkamp JJ, Hayes NA, Lengel GJ, Styer DM, Washburn JJ. Characterizing gender differences in nonsuicidal self-injury: Evidence from a large clinical sample of adolescents and adults. Compr Psychiatry. 2018 Apr;82:53-60. doi: 10.1016/j.comppsych.2018.01.009. Epub 2018 Feb 4. Erratum in: Compr Psychiatry. 2018 Oct;86:143. doi: 10.1016/j.comppsych.2018.07.011. PMID: 29407359; PMCID: PMC5845831.